Gonadal function in men with testis cancer

Area of Science:

• Reproductive Endocrinology
• Oncology
• Andrology

Background:

• Unilateral germinal testicular cancer necessitates evaluation of contralateral testicular function.
• Assessing gonadal reserve is crucial before commencing cancer treatments like chemotherapy and irradiation.

Purpose of the Study:

• To investigate the status of spermatogenesis and hormonal function in the contralateral testis of patients with unilateral germinal testicular cancer.
• To identify the prevalence of testicular damage and hormonal imbalances in these patients prior to treatment.

Main Methods:

• Biopsy of the contralateral testis, semen analysis, and serum hormone level measurements (testosterone, LH, FSH) were performed in 218 patients.
• Analyses were conducted after orchidectomy but before irradiation and chemotherapy.

Main Results:

• 24% of testicular biopsies revealed severe irreversible changes, including spermatogenic arrest, Sertoli cell-only tubules, hyalinized tubules, or carcinoma in situ.
• 13% of patients had below-normal serum testosterone (T) levels.
• 12% had normal serum T with elevated serum luteinizing hormone (LH), and most patients exhibited elevated serum follicle-stimulating hormone (FSH) levels.

Conclusions:

• A significant proportion of patients with unilateral testicular cancer exhibit impaired contralateral testicular function.
• Factors contributing to gonadal dysfunction include contralateral testicular defects, hormonal imbalances, and cancer-related hormonal changes (e.g., elevated hCG).
• These findings highlight the need for comprehensive fertility assessment and potential fertility preservation strategies in testicular cancer patients.